Abstract: Background Traditional Chinese Medicine（TCM） plays a significant role in diabetes management by alleviating clinical symptoms，preventing complications，enhancing glycemic control，and improving quality of life. Physicians are the cornerstone of clinical practice. However，there remains a paucity of surveys investigating physicians' current utilization and unmet needs regarding TCM-based diabetes prevention and treatment strategies. Objective To investigate the application status and needs of physicians in different level hospitals of TCM prevention and treatment measures for diabetes. Methods A cross-sectional survey was conducted among physicians across 192 cities in 30 provinces of China from September 22，2021 to October 29，2021，using the snowball sampling method in the form of online self-filled questionnaires. Data collected included participants' demographic information，current utilization of TCM-based diabetes prevention/treatment measures，and perceived needs. Rank-transformed nonparametric tests were used for comparative analysis among physicians from different hospital tiers.Results A total of 1150 physician samples were included in the analysis，556 males（48.35%） and 594 females（51.65%），with a mean age of 40.9±8.8 years. By specialty，606（52.70%） physicians specialized in TCM，while 544（47.30%）physicians specialized in clinical medicine. Among TCM practitioners，utilization frequencies of herbal decoctions，Chinese patent medicines，herbal granules，herbal fumigation，acupoint application，and auricular therapy differed significantly across hospital tiers（all P<0.05）；similarly，among clinical medicine practitioners，utilization frequencies of herbal decoctions，herbal granules，acupuncture，herbal fumigation，and auricular therapy showed statistically significant differences across hospital tiers（all P<0.05）. Notably，physicians specialized in TCM reported higher rates of "regular or frequent use" for TCM dietary therapy（84.16%），herbal decoctions（67.82%），and Chinese patent medicines（50.50%）；clinical medicine practitioners most commonly used Chinese patent medicines（42.10%） and TCM dietary therapy（39.71%）. Physicians across hospital tiers predominantly employed TCM interventions for diabetes complications，clinically apparent symptoms，or prediabetes，primarily aiming to alleviate symptoms，treat complications，and enhance conventional therapy synergy. Significant inter-tier differences emerged among TCM practitioners in diabetes-related knowledge domains：Chinese patent medicines，herbal formulations，standardized TCM techniques，traditional exercises，theoretical knowledge，syndrome interpretation，and pattern differentiation（all P<0.05），whereas clinical medicine practitioners showed tier-based differences in standardized TCM technique application（P=0.004）.Conclusions Physicians from different specialties and hospital tiers demonstrated distinct patterns in both current practices and needs regarding TCM-based diabetes prevention and treatment. Future training programs should be tailored to these professional characteristics，with particular emphasis on enhancing primary care physicians' competencies through targeted TCM intervention training initiatives.

Key words: Diabetes mellitus, Traditional Chinese Medicine, Physicians, Questionnaire investigation, Application Status, Demands analysis

摘要： 背景 中医药在糖尿病防治中发挥着改善临床症状、防治并发症、协同降糖及提高生活质量等重要作用，医师是医疗行为的核心力量。目前，关于医师对糖尿病中医防治措施应用现状与需求的调查尚较缺乏。目的 调查了解中国各级医院医师对糖尿病中医药防治措施的应用现状及需求。方法 于2021年9月22日—2021年10月29日采用滚雪球抽样方法向全国范围内30省192市的医师进行横断面调查，收集研究对象基本信息、医师对中医药防治措施的使用现状与需求情况等，采用秩转换的非参数检验方法进行各级医院医师间的比较分析。结果 共纳入1150份医师样本，其中男556名（48.35%），女594名（51.65%）；平均年龄（40.9±8.8）岁；606名（52.70%）从事中医专业，544名（47.30%）名从事临床医学专业。临床诊疗糖尿病时，不同级别医院从事中医专业医师对汤剂、中成药、中药颗粒剂、中药熏洗、穴位贴敷、耳穴的使用频率比较，差异具有统计学意义（P均 <0.05）；不同级别医院从事临床医学专业的医师对汤剂、中药颗粒剂、针灸、中药熏洗、耳穴的使用频率比较，差异有统计学意义（P均 <0.05）；其中，从事中医专业医师对中医食疗（84.16%）、汤剂（67.82%）、中成药（50.50%）3 类中医防治措施“完全使用或经常使用”的比例较高，从事临床医学专业医师对中成药（42.10%）和中医食疗（39.71%）“完全使用或经常使用”的比例较高。不同级别医院医师主要在患者出现糖尿病并发症、患者临床症状明显时、糖尿病前期的情况下采用中医药治疗措施。不同级别医院医师使用中医治疗糖尿病主要解决的问题包括改善糖尿病症状、治疗并发症、协同西医疗法增强疗效。不同级别医院从事中医专业的医师对糖尿病使用中成药、中药方剂知识、中医适宜技术、传统锻炼功法、中医理论知识、中医证候说明、中医辨证分型说明等中医知识的认知情况的比较，差异均具有统计学意义（P均 <0.05）；不同级别医院从事临床医学专业的医师对糖尿病中医适宜技术操作的认知比较，差异具有统计学意义（P=0.004）。结论 不同专业、不同级别医院的医师对糖尿病中医防治措施的应用现状和需求存在各自特点和差异。今后应根据医师的需求和特点制定培训方案，加强对基层医师的培训力度，重点制定有针对性和侧重性的中医防治措施培训推广方案。

关键词: 糖尿病, 中医药, 医师, 问卷调查, 应用现状, 需求分析